MRI平扫方案膀胱影像报告和数据系统对膀胱癌肌层浸润的诊断价值  

Diagnosis of Vesical Imaging-Reporting and Data System of MRI in Muscular Infiltration of Bladder Cancer

作　　者：王玮[1] 王鹤[1] 吴静云[1] 李玮[1] 曹新鸣[1] 薛珂 邱建星[1] WANG Wei;WANG He;WU Jingyun;LI Wei;CAO Xinming;XUE Ke;QIU Jianxing(Department of Radiology,Peking University First Hospital,Beijing 100034,China;不详)

机构地区：[1]北京大学第一医院医学影像科,北京100034 [2]上海联影医疗科技股份有限公司中央研究院,上海201807

出　　处：《中国医学影像学杂志》2023年第5期517-521,528,共6页Chinese Journal of Medical Imaging

摘　　要：目的 探究MRI平扫方案膀胱影像报告和数据系统(VI-RADS)评分对膀胱癌肌层浸润的诊断效能,探究定量参数肿瘤接触径线(TCL)对平扫VI-RADS评分的补充诊断价值。资料与方法 回顾性收集2020年10月—2021年8月于北京大学第一医院行膀胱多参数MRI增强检查患者60例,以术后病理结果为诊断标准。测量肿瘤基底部与膀胱壁的最大TCL,在两组磁共振图像((1)平扫组:T2WI+扩散加权成像(DWI);(2)增强组:T2WI+DWI+DCE)上对膀胱癌进行VI-RADS评分,通过受试者工作特征曲线下面积(AUC)评价其诊断效能。结果 60例患者中,39例行经尿道电切手术,21例行根治性膀胱全切,最终37例(61.7%)诊断为非肌层浸润膀胱癌,23例(38.3%)诊断为肌层浸润膀胱癌。平扫组与增强组VI-RADS评分AUC比较,差异无统计学意义(0.948比0.954,P>0.05)。肌层浸润膀胱癌的TCL值[2.90(2.10,4.90)cm]大于非肌层浸润膀胱癌[1.40(0.85,2.00)cm](Z=4.171,P<0.001),其诊断肌层浸润膀胱癌的AUC为0.822。TCL联合平扫VI-RADS评分诊断肌层浸润膀胱癌AUC为0.953,较单独使用平扫VI-RADS评分略提升。结论 MRI平扫方案膀胱VI-RADS评分具有较高的肌层浸润诊断能力,联合定量参数TCL值可进一步提高其诊断效能。Purpose Toexplore the diagnostic value of vesical imaging-reportingand data system(VI-RADS)ofMRIscoring on muscular invasion of bladder cancer,and to explore the complementary diagnostic value of quantitative parameter tumor contact length(TCL)on plain scan VI-RADS scoring.Materials and Methods Sixty patients were retrospectively enrolled from October 2020 to August 2021 in Peking University First Hospital,using postoperative pathological results as diagnostic criteria.The maximum TCL of tumor base and bladder wall was measured,and VI-RADS score was performed on the MRI images of the two groups.(1)Plain scan group:T2WI+diffusion weighted imaging(DWI).(2)Enhancement group:T2WI+DWI+dynamic contrast enhanced.The diagnostic efficiency was evaluated by area under the curve(AUC)ofreceiver operating characteristic curve.Results Of 60 patients,39 underwent transurethral resection and 21 underwent radical total bladder resection.Finally,37(61.7%)were diagnosed with non-muscular invasive bladder cancer and 23(38.3%)were diagnosed with muscular invasive bladder cancer.There was no significant difference in AUC of VI-RADS score between the plain scan group and the enhancement group(0.948 vs.0.954,P>0.05).The TCL value of 2.90(2.10,4.90)cm was significantly higher than that of 1.40(0.85,2.00)cm for non-invasive bladder cancer(Z=-4.171,P<0.001),and the AUC for the diagnosis of muscular invasive bladder cancer was 0.822.The AUC of TCL combined plain scan VI-RADS for the diagnosis of muscular infiltrating bladder cancer was 0.953,slightly higher than that of plain scan VI-RADS alone.Conclusion VI-RADS score of noncontrast scheme has high diagnostic ability of muscular infiltration,and combined with TCL value can further improve its diagnostic ability.

关 键 词：膀胱肿瘤 磁共振成像 数据系统 病理学 外科 

分 类 号：R737.14[医药卫生—肿瘤] R445.2[医药卫生—临床医学]